HOSPITAL OF 96TH
REGIMENT.
A CASE OF SCARLATINA MALIGNA.
Eeported by Surgeon H. Mitchell, II. M.'s 96tli Regitnent. No. 725, Private L aged 20 years, 5 years' service, two of which were passed in India. Temperament sanguineous; habits moderate. This man presented himself at hospital on the morning of the 28th of February, 1868, and stated that he had been suffering for a few days from lassitude, slight headache, ,
and disinclination to food, &c. Admitted under the of Dr. O'Brien, with all the symptoms of continued fever, but of an aggravated type, attended with great suffusion of the eyes and frontal headache. Ordered diaphoretic mixture every three hours, and perfect quietude. Vespere.?Complains of severe pains over the promontory of the sacrum, increased on the slightest motion, and on inspiration ; there is also a scarlet colored eruption over the neck and back. (Case isolated.) Treatment.?Bowels being sluggish, to have a purgative: diaphoretic continued, and dry cupping to the loins. 29th.?Passed a restless and wakeful night. The scarlet eruption has extended over the whole of the body; it is diffused and disappears on pressure. The pain in the lower part of the back is excruciating; it is especially severe over the upper portion of the sacrum, but is not increased on pressure; pulse quick and full; pungent heat of skin and suffusion of eyes continue, but in a greater degree; slight frontal headache; tongue dry, brown and glazed; no difficulty of deglutition or breathing; and no enlargement of tonsils or cervical glands exist at present; gums and Hps covered with sordes, and he suffers from urgent thirst; bowels freely acted upon by the medicine. Continue diaphoretic ; to have chlorate of potash in barley water frequently. Kidneys up to this stage have been acting freely. 11 o'clock a.m.?Pain over the sacrum very severe, extreme restlessness. Pulse quick and moderately full; skin hot and thirst still urgent; the eruption intermixed with some petichial spots over chest; conjunctivae deeply suffused; tonsils enlarged, and apparently gorged with blood, breathing not affected. Fomentations to seat of pain, gargle of chlorate of potash, and continue the diaphoretic. 3 p.m.?Very restless, to have a draught of Batley's sedative. 5 p.m.?Slept a short time after the draught. The pain in the back has suddenly subsided, and lie states that he feels so much better; body has assumed a dusky pinkish hue, intermixed with numerous petechia;; great effusion of blood into the conjunctivae, which apparently increases ; surface of body warm; tongue still presents the same appearance; sordes thickly encrusted over teeth and lips; pulse feeble and quick, having been moderately full at 12 o'clock noon. This sudden fall of temperature and pulse, together with the effusion of blood beneath the cuticle, makes the case assume a very serious aspect. Ordered carbonate of ammonia in 5 grain doses frequently repeated, with a liberal allowance of wine and beef-tea. 9-30 p.m.?Has suddenly expired: while talking to the orderly in attendance upon him (quite rational), when he became suddenly convulsed and died in a short time. Owing to the advanced state of decomposition the body was in next morning, it was deemed advisable to have it encased and interred without a post-mortem. Remarks.?This case is only interesting in a medical point of view, from the doubtful existence of the disease in India. However, the discussion in the June number of the Indian Medical Gazette has induced me to lay this resume of it before the profession, as it may assist in carrying conviction to the minds of those who appear to have the belief that scarlatina is altogether unknown in India. In the above case, the affection of the throat was very slightly marked, but in some cases this occurrence is not essential to the malignity of the disease. It is to be hoped that the interesting discussion which is at present going on regarding this disease will induce medical officers to put forward any authentic accounts of the occurrence (in India) of scarlatina they may have. The following few notes of a case of simple scarlatina have been kindly placed at my disposal by Assistant Surgeon 0. Sullivan, 96th Itegiment, which occurred in his practice when Station Staff Surgeon at Dum-Dum in 1870. Mr. K. After a few days of indisposition, an eruption of scarlatina made its appearance. The eruption throughout wa3 thirst care
.
212
THE INDIAN MEDICAL GAZETTE.
;aiigkt, cut the festooned outlines were very manifest; plications, and sore throat very slight. The case terminated favorably in the usual manner. Dinapore.
no com-
[October 2,
1871.
REGIMENT.
A CASE OF SCARLATINA MALIGNA.
Eeported by Surgeon H. Mitchell, II. M.'s 96tli Regitnent. No. 725, Private L aged 20 years, 5 years' service, two of which were passed in India. Temperament sanguineous; habits moderate. This man presented himself at hospital on the morning of the 28th of February, 1868, and stated that he had been suffering for a few days from lassitude, slight headache, ,
and disinclination to food, &c. Admitted under the of Dr. O'Brien, with all the symptoms of continued fever, but of an aggravated type, attended with great suffusion of the eyes and frontal headache. Ordered diaphoretic mixture every three hours, and perfect quietude. Vespere.?Complains of severe pains over the promontory of the sacrum, increased on the slightest motion, and on inspiration ; there is also a scarlet colored eruption over the neck and back. (Case isolated.) Treatment.?Bowels being sluggish, to have a purgative: diaphoretic continued, and dry cupping to the loins. 29th.?Passed a restless and wakeful night. The scarlet eruption has extended over the whole of the body; it is diffused and disappears on pressure. The pain in the lower part of the back is excruciating; it is especially severe over the upper portion of the sacrum, but is not increased on pressure; pulse quick and full; pungent heat of skin and suffusion of eyes continue, but in a greater degree; slight frontal headache; tongue dry, brown and glazed; no difficulty of deglutition or breathing; and no enlargement of tonsils or cervical glands exist at present; gums and Hps covered with sordes, and he suffers from urgent thirst; bowels freely acted upon by the medicine. Continue diaphoretic ; to have chlorate of potash in barley water frequently. Kidneys up to this stage have been acting freely. 11 o'clock a.m.?Pain over the sacrum very severe, extreme restlessness. Pulse quick and moderately full; skin hot and thirst still urgent; the eruption intermixed with some petichial spots over chest; conjunctivae deeply suffused; tonsils enlarged, and apparently gorged with blood, breathing not affected. Fomentations to seat of pain, gargle of chlorate of potash, and continue the diaphoretic. 3 p.m.?Very restless, to have a draught of Batley's sedative. 5 p.m.?Slept a short time after the draught. The pain in the back has suddenly subsided, and lie states that he feels so much better; body has assumed a dusky pinkish hue, intermixed with numerous petechia;; great effusion of blood into the conjunctivae, which apparently increases ; surface of body warm; tongue still presents the same appearance; sordes thickly encrusted over teeth and lips; pulse feeble and quick, having been moderately full at 12 o'clock noon. This sudden fall of temperature and pulse, together with the effusion of blood beneath the cuticle, makes the case assume a very serious aspect. Ordered carbonate of ammonia in 5 grain doses frequently repeated, with a liberal allowance of wine and beef-tea. 9-30 p.m.?Has suddenly expired: while talking to the orderly in attendance upon him (quite rational), when he became suddenly convulsed and died in a short time. Owing to the advanced state of decomposition the body was in next morning, it was deemed advisable to have it encased and interred without a post-mortem. Remarks.?This case is only interesting in a medical point of view, from the doubtful existence of the disease in India. However, the discussion in the June number of the Indian Medical Gazette has induced me to lay this resume of it before the profession, as it may assist in carrying conviction to the minds of those who appear to have the belief that scarlatina is altogether unknown in India. In the above case, the affection of the throat was very slightly marked, but in some cases this occurrence is not essential to the malignity of the disease. It is to be hoped that the interesting discussion which is at present going on regarding this disease will induce medical officers to put forward any authentic accounts of the occurrence (in India) of scarlatina they may have. The following few notes of a case of simple scarlatina have been kindly placed at my disposal by Assistant Surgeon 0. Sullivan, 96th Itegiment, which occurred in his practice when Station Staff Surgeon at Dum-Dum in 1870. Mr. K. After a few days of indisposition, an eruption of scarlatina made its appearance. The eruption throughout wa3 thirst care
.
212
THE INDIAN MEDICAL GAZETTE.
;aiigkt, cut the festooned outlines were very manifest; plications, and sore throat very slight. The case terminated favorably in the usual manner. Dinapore.
no com-
[October 2,
1871.
